73 manuscripts met the criteria of the systematic search. 53 papers (72.6%) reported the term anterolateral approach to describe a complete intermuscular approach between the interval between GM and TFL. Nonetheless, in the remaining 20 papers (27.4%) the term anterolateral was used to describe intramuscular approaches in which the gluteus medius was violated.
In about 1 out of 4 papers in the recent literature, the term anterolateral was utilised to describe approaches that are completely different both in terms of anatomy and function.
In about 1 out of 4 papers in the recent literature, the term anterolateral was utilised to describe approaches that are completely different both in terms of anatomy and function.Dual mobility (DM) has been shown to improve stability both in primary and revision total hip arthroplasty (THA) and is increasingly used in patients at high risk of dislocation and in the treatment of THA instability. The introduction of modular liners has helped to overcome some of the limitations of monoblock DM cups. In this context, the use of a ceramic liner would avoid the conventional cobalt-chromium liner in the titanium shell, which can be problematic in some situations. The aim of this paper is to report the outcomes of a consecutive series of patients undergoing revision THA using a modular DM cup with a ceramic liner instead of the conventional metal one, and to clarify the rationale for this currently "off-label" use.
This is a retrospective series of patients who received this new DM bearing in a single institution. Patients were followed up clinically and radiologically at 1?month, 3?months, 6?months and yearly thereafter.
5 patients received the ceramic liner in the study period (2014-2are needed to confirm these findings and before widespread use of the device.The number of femoral neck fractures (FNFs) worldwide will drastically increase in the next few decades, reaching 6.3 million by 2050. In the future, therefore, newly-qualified orthopaedic surgeons will treat this kind of injury more frequently than in past decades. This prospective observational study aims to assess whether hip hemiarthroplasty with modular neck, performed via the Hardinge approach, can be safely carried out by orthopaedic residents.
Patients referred to our Level I trauma centre, between January 2016 and June 2017, with displaced intra-articular femoral fractures, were prospectively recruited. All patients underwent cemented modular bipolar hip hemiarthroplasty (Profemur Z, MicroPort Orthopedics Inc., Arlington, TN, USA) via the Hardinge approach, with the patient positioned in lateral decubitus. The surgical procedures were performed by the same surgical and anesthesiology team, under spinal anaesthesia. All patients underwent clinical and radiographic follow-up up to 24?months. Compli002). The length of hospital stay and the mean clinical scores at 24?months follow-up showed no significant differences.
Hip hemiarthroplasty with modular neck can be safely employed during the learning curve of orthopaedic residents. Great efforts, however, should be made in future to improve residents' training in the management of FNFs.
Hip hemiarthroplasty with modular neck can be safely employed during the learning curve of orthopaedic residents. Great efforts, however, should be made in future to improve residents' training in the management of FNFs.Aim of this study was to evaluate acetabular bone vitality during revision hip arthroplasty and to compare the bone quality between revision and primary acetabular arthroplasty.
During primary and revision total hip arthroplasty surgeries, biopsies were taken from the acetabulum after reaming. The samples (osteochondral cylinders of approximately ?1?cm long and 3?mm thickness), after removing the mineral component, were cut longitudinally with a thickness section of 5??m and colored with hematoxylin-eosin dichromic dye and then evaluated histologically by optical microscopy with 40× magnification. Preoperative radiographs were evaluated.
According to inclusion and exclusion criteria, 14 patients formed the revision group patients (mean age 67.9?years, average time before revision 8.8?years, SD?±?7.06) and 5 patients formed the control primary group (mean age 61.4?years). The bone quality of the revision group was generally poorer than the primary group, while similar vitality and bone quality has been found between septic and aseptic group. Variables such as age, gender and BMI did not significantly contribute to define bone quality classes.
The study confirms the differences in quality and bone vitality between cases and controls and the necessity to find strategies to improve the osteointegrative processes in revision arthroplasties.
The study confirms the differences in quality and bone vitality between cases and controls and the necessity to find strategies to improve the osteointegrative processes in revision arthroplasties.Dislocation after total hip arthroplasty (THA) is the most common cause of revision hip surgery in the United States, ahead of aseptic loosening and infection, and is responsible for considerable economic cost related to frequent readmission and/or revision surgery. The aim of this article is to identify the clinical and radiological factors related to the unstable total hip replacement.
We performed a literature search to assess current strategies to define clinical and radiological characteristics of dislocation after primary THA using the PubMed platform. The characteristics related to THA instability were divided into patient related factors, implant related factors and surgeon experience.
Patient-related factors for instability identified are age; inflammatory joint disease; prior hip surgery; preoperative diagnosis; comorbidity; ASA score; presence of spino-pelvic abnormality; and neurological disability. Gender, simultaneous bilateral THA and restrictive postoperative precautions do not influence rate of THA dislocation. Implant related factors identified are surgical approach; component malposition; femoral head size; and the use of dual-mobility or constrained solution. https://www.selleckchem.com/products/rgt-018.html Surgeon experience also reduces the rate of dislocation.
Dislocation is a major complication of THAs, and causes include patient-derived factors, surgical factors, or both. It is imperative to determine the cause of the instability via a complete patient and radiographic evaluation and to adjust the reconstruction strategy accordingly.
Dislocation is a major complication of THAs, and causes include patient-derived factors, surgical factors, or both. It is imperative to determine the cause of the instability via a complete patient and radiographic evaluation and to adjust the reconstruction strategy accordingly.